Kratom: A Safe and Effective Opioid Alternative?

Unbeknownst to many, there is a leaf used by millions in the United States to treat chronic pain, depression, anxiety, and opiate withdrawal symptoms.  It is from the Kratom tree, which grows in Southeast Asian countries, including Thailand and Malaysia.  The federal government has been attempting to ban the use of the herb for years.  

A recent study at Johns Hopkins University, sponsored by the National Institute on Drug Abuse, seems to point to the conclusion that Kratom may be a safe and effective opioid alternative.

The study on Kratom was published in Drug and Alcohol Dependence in early February 2020.  The study consisted of an online survey of over 2500 kratom users.  The survey was anonymous.  Nearly sixty percent of those surveyed reported daily use of Kratom.  Dosages of one to three grams were the most common.

Over ninety percent of those surveyed used Kratom for pain, sixty-five percent used it for depression (high effectiveness noted), and sixty-seven percent employed the herb for help with anxiety symptoms.  Over forty percent of the respondents were using Kratom to reduce or cease illegal usage of opioids. A third of that group reported they could stay off opiates for more than a year because of Kratom.

Mild side effects from Kratom were reported by about a third of those surveyed.  The most common side effects were constipation, lethargy, and stomach upset.  Of the respondents who reported side effects, a tiny percentage (less than one percent) actually sought treatment for them.

A small percentage of those responding, two percent, met the criteria for a substance abuse disorder based on their use of Kratom.  Any concern over the responders' use of Kratom was self-reported as 3.2 on a 0-100 scale.

The U.S. Drug Enforcement Administration (DEA) defines a schedule one drug with a high potential for abuse and no accepted medical use.

Researchers at Johns Hopkins University say the findings from the anonymous survey suggest that there is no justification to qualify Kratom as a Schedule I drug since the abuse potential is low and that it appears to have medical benefits, including pain relief and a potential treatment for opiate abuse.

Still, for years the DEA has been advocating to classify Kratom as a Schedule I drug.

The Johns Hopkins researchers argue that fewer than 100 reported deaths related to kratom use in 2017. In contrast, that same year bears the statistic of over 47,000 overdose deaths related to opioids.  Most of the kratom-related deaths involved a combination of other drugs or preexisting health conditions.  The researchers felt that the government's fear over Kratom is related to the opioid crisis since Kratom offers opioid-like effects.

In 2016, Pain News Network embarked on an online survey of over 6000 kratom users.  Ninety percent of respondents described Kratom as useful for insomnia, anxiety, depression, pain, alcoholism, and opioid addiction.  Fewer than one percent of respondents said it was not effective.  A high percentage of effectiveness was reported for symptoms caused by many medical conditions, including multiple sclerosis, migraine, acute pain, neuropathy, and cancer, just to name a few.

There is much speculation that the DEA's push to get Kratom classified as a Schedule I drug is not based on a patient safety concern but rather an attempt to protect pharmaceutical corporation profits.  The herb has been used for medicinal purposes for centuries throughout Asia, and it is estimated that 10-16 million Americans regularly use the substance.

Despite its apparent safety and effectiveness, the DEA's campaign seems to be working.  Kratom is banned in Wisconsin, Vermont, Indiana, Rhode Island, Arkansas, and Alabama.  Other states are also considering banning the substance.

In the video below, several guests on The Doctors discuss the potential regulation of Kratom.

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Editor's Note: This page has been updated for accuracy and relevancy [cha 9.29.21]

Photo Attribution: Jeon Sang-O from Pixabay

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